NIH DIRECTOR ZERHOUNI ASSESSES POSSIBILITIES FOR

UNCLAS TUNIS 000423

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STATE FOR NEA/MAG (LAWRENCE),OES/H
HHS PLEASE PASS TO NIH (JUDY LEVIN) AND OGHA/DHHS (JANE
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TAGS: PREL PGOV PHUM TBIO KPAO SOCI NIH OVIP MEPI
TS

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SUBJECT: NIH DIRECTOR ZERHOUNI ASSESSES POSSIBILITIES FOR
RESEARCH IN TUNISIA

REF: TUNIS 161 (NOTAL)


1. SUMMARY. National Institute of Health (NIH) Director Dr.
Elias Zerhouni accompanied by a multi-disciplinary team,
visited Tunis January 19-21 to understand research priorities
and related GOT commitment. The team was impressed with the
state of care and research in Tunisia; found the involved
ministries and institutions to be willing partners for
collaborations and development toward higher global standards
of research; and identified possible individuals for future
exchanges and collaborations. The group summarized the
Tunisian experience by stating that the country has excellent
human capital, close research ties with France that could be
built upon by U.S. researchers, and a patient population and
health care system that would support clinical trials.
Tunisia could also be an important collaborator in
South-South activities associated with women's health, due to
its embrace of equality for women, excellent access to family
planning, and the past effort made to bring women fully into
all levels of the Tunisian educational system. END SUMMARY.


2. The National Institute of Health (NIH) team included NIH
Director Dr. Elias Zerhouni and members from three of the 27
institutes that fall under the NIH aegis: The National
Institute of Child Health and Human Development (NICHD),the
National Institute of Allergy and Infectious Diseases
(NIAID),and the Fogarty International Center (FIC). Both
NICHD and NIAID have a history of providing funding to low
and middle income countries, while FIC's primary focus is
international capacity building. The group concentrated
their attention on infectious diseases and child/maternal
health, but also investigated crosscutting issues, such as as
bioethics, infectious diseases, newborn screening,
consanguinity and general capacity building. (NOTE: In
Tunisia, there is an incidence of consanguinous marriages as
high as 60 percent in many rural areas. This practice, which
causes genetic abnormalities, was a major focus of the visit
and has implications for further study as a regional
initiative. END NOTE.)


3. The overarching goals for the trip were to establish
contacts; evaluate the state of scientific research
capabilities; learn about research priorities in Tunisia and
assess the government's commitment to those priorities;
determine current sources of funding; and promote
possibilities for further exchanges and collaboration. The
visitors met with Prime Minister Mohamed Ghannouchi, who
stressed GOT commitment to biotechnology and the development
of a world-class research facility in the southern city of
Sfax. The team also met with ministers of Public Health;
Scientific Research, Technology and Promotion of Skills; and
Education and Training. The group visited medical research
institutes, training facilities, and public hospitals in
Tunis where research is being done and consulted with a wide
spectrum of working-level scientists.


4. Overall, the group had positive impressions of the state
of medical research in Tunisia, and they were impressed with
the general care of patients in those facilities. The group
summarized the Tunisian experience by stating that the
country has excellent human capital, close research ties with
France that could be built upon by U.S. researchers, and a
patient population and health care system that would support
clinical trials. They also felt that it would be valuable
for Tunisian institutions to begin development of
Institutional Review Boards (IRBs) that oversee the
protection of human subjects in clinical trials, and any
other necessary structures to be able to meet "Federalwide
Assurance" and U.S. Human Protection requirements. Both of
these standards are necessary to establish clinical trials
supported by NIH funding.


5. Tunisia could also be an important collaborator in
South-South activities associated with women's health, due to
its embrace of equality for women, excellent access to family
planning, and the past effort made to bring women fully into
all levels of the Tunisian educational system. The Ministry
of Public Health has done fine work promoting family planning
options, effectively reducing population growth to 1.2
percent. As a consequence, the Ministry is now addressing
more comprehensive women's health issues, including breast
and cervical cancer screening, reproductive health, as well
as behavioral interventions to reduce sexually-transmitted
diseases and prevent HIV/AIDS. Notably, the success within


Tunisia has resulted in Tunisia developing a South-South
pilot program on women's health issues for Niger, jointly
funded by the Bill and Melinda Gates Foundation and the UNDP.



6. Dr. Zerhouni's visit clearly indicates that visits by
high-profile Arab Americans reduce the cultural dissonance
that challenges our outreach efforts (see reftel). This is
particularly true when such interlocutors are engaged in
mutually beneficial areas, such as science, technology, and
medical cooperation -- areas which in themselves support
increased transparency, creativity and modernization in the
Arab world. Dr. Zerhouni's natural grace and in-depth
knowledge of this part of the world make him a natural
interlocutor to promote the American values of diversity,
tolerance, openness, and the role of merit in our society.
HUDSON